CECHE Center for Communications, Health and the Environment
Winter 2002 Vol. 10, Issue 1
Partnerships Promote Global Health
World Health Report '02 Makes Prevention Top Global Priority

This year's World Health Report, "Reducing Risks, Promoting Healthy Life," (www.who.int/whr) provides powerful reasons for greater investment in disease prevention and health promotion.

The report documents the impact of major risks for death and disease, and provides a template to help policy-makers orient their work towards tackling major health risks. It also highlights the cost-effectiveness of many policy measures at population and individual levels. In a report of the Macroeconomic Commission on Health, for example, Jeff Sachs placed the cost-effectiveness of tobacco control in developing countries at par with tuberculosis, malaria and measles control. And WHO estimates that improved tobacco control could potentially avert most of the 5 million deaths attributed to tobacco use worldwide.

The report provides compelling data. In developed countries, and in lower middle-income countries such as Brazil, China and Thailand, six of the top 10 risks to health are directly related to cardiovascular disease (CVD), cancers and other chronic diseases, it reveals. These risks include tobacco use, high blood pressure, high blood cholesterol, increased body mass, low fruit and vegetable consumption, excess alcohol intake and physical inactivity

“More than 1 billion adults worldwide are overweight, and at least 300 million are clinically obese. Among these, about half a million people in North America and Western Europe combined will have died this year from obesity-related diseases,” laments Gro Harlem Brundtland, director of the World Health Organization (WHO). And several of these same risk factors — high blood pressure, tobacco use and high cholesterol — have now emerged in the top 10 in sub-Saharan Africa and south Asia, where, combined with undernutrition and infectious diseases, they double the disease burden in these poorest of nations.

“The rapidly growing epidemic of noncommunicable diseases, already responsible for some 60 percent of world deaths, is clearly related to changes in global dietary patterns and increased consumption of industrially processed fatty, salty and sugary foods,” states Dr. Brundtland. “In the slums of today’s megacities, we are seeing noncommunicable diseases caused by unhealthy diets and habits, as well as undernutrition.”

Thus the report confirms that death and disease from CVD and diabetes have become commonplace in developing countries like India and China. Meanwhile, it reveals, few countries have policies for chronic disease control, and fewer provide basic diagnostic and treatment options in their primary health care settings.

The message is clear: risks for chronic diseases are now global — the capacity to address them is not. This poses an enormous challenge for developing countries, which need to invest in effective prevention now if future CVD and cancer epidemics are to be contained.

The good news is that major initiatives are now underway to address these associated risks and diseases in a more integrated and effective way. Here are three:

  1. The Framework Convention on Tobacco Control (http://www5.who.int/tobacco/) is raising the level of priority for tobacco control worldwide. With the final negotiating round in early 2003, expectations are realistically high that a treaty will emerge that will substantially enhance tobacco control at country level.
  2. A new strategy for promoting a healthy diet and physical activity (http://www.who.int/hpr/NPH/docs/GlobalStrategy.pdf) will lead to new global partnerships among food and related sectors, nongovernmental organizations (NGOs) and consumer groups, and the broader United Nations family and academic groups.
  3. The move to transform health services from their current focus on acute, episodic care towards an emphasis on the importance of prevention and long-term care is a revolution in evolution (http://www5.who.int/noncommunicable-diseases/main.cfm?p=0000000774).

WHO alone cannot tackle the challenges described above; the organization seeks strong alliances with NGOs that support the same public health goals and principles it is advancing. CECHE has demonstrated its commitment to addressing tobacco control and promoting healthy diets in work that stretches over a decade, and WHO looks forward to strengthened collaboration with this NGO in tackling the major risks to global health. Together, we can make a global difference to future well-being. [back to front page....]

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